Registration – RSM Samlarc

IMPORTANT MESSAGE:

Use the form below only for Rancho Santa Margarita Samlarc Camps. For other facilities, please click here to go to the specific registration form. Please review our Class Schedules prior to registration.

Welcome to our Registration page. When you register, your child will bring home these items with him or her:

A FREE Bionerds T-shirt (while supplies last, so let’s get started!).

A little “live friend” as a reward for good behavior in class (surely with your permission and psstttt…don’t tell your child. It’s a surprise). If you prefer non-live toys instead, please let us know. It’s totally fine.

Important Note: RSM Summer Camp on week 6/11-6/15 has been canceled. The camp on week 8/20-24 is OPEN.

Child's Name:*

First

Last

Sex:*

Birthdate:*

/

/

day

month

year

School Name:*

Grade:*

Parent/Guardian's Name:*

First

Last

Relationship to child:*

E-mail:*

Address:*

Street AddressCityStatePostal / Zip Code

Phone:*

Area Code

-

Phone Number

Next

Known Allergies:*

List known allergies:

Special health need(s)? (We do not administer medication to your child)*

Special health need or accommodation request? (We will try our best but not guaranteed)

Emergency Contact:*

Emergency Contact Phone No:*

Area Code

-

Phone Number

Relationship to Child:*

Waiver form needs to be signed and submitted on the first day of class.*

I understand

I have read the Bionerds Sexual Abuse and Misconduct Prevention Policy and understood the content.*

Yes

I have read the Bionerds Laboratory Rules and Safety Guidelines and agreed to review it with my child.*

Yes

Previous

Next

Join our mailing list?:*

How did you hear about us?*

Select your FREE T-Shirt Size:*

Select Session*

We may send home a little "live friend" (such as cricket, ladybug, worms, etc. depending on the topics) with your child during the session. We want to make sure our little friend is welcome and taken care of. Are you okay with that?*